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双相障碍门诊患者的认知障碍与精神卫生保健资源的消耗。

Cognitive impairment and consumption of mental healthcare resources in outpatients with bipolar disorder.

机构信息

Department of Mental Health, La Ribera University Hospital, Carretera Corbera Km 1 s/n 46600, Alzira, Valencia, Spain.

Intelligent Data Analysis Laboratory (IDAL) University of Valencia, Avenida Universitat s/n 46100, Burjassot, Valencia, Spain.

出版信息

J Psychiatr Res. 2021 Jun;138:535-540. doi: 10.1016/j.jpsychires.2021.05.003. Epub 2021 May 7.

Abstract

Cognitive dysfunction is a major predictor of functional outcomes, and loss of occupational functioning is usually linked with a higher cost of illness. However, the association between cognitive impairment and consumption of health resources has not been studied in bipolar disorder to date. This study aims to examine this relationship. This is an observational, retrospective study of a representative sample of euthymic outpatients between 18 and 55 years, fulfilling DSM 5 criteria for bipolar disorder and recruited at a catchment area in Spain. Cognitive performance was screened with the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S), and several variables of health resources consumption during the previous year were registered. A total of 72 patients were assessed. Cognitive impairment according to the SCIP-S was significantly associated with the number of scheduled clinical appointments (p < 0.005) and hospital admissions (p < 0.04) but not with other health resources consumption variables. These results need to be interpreted with caution given that neither a control group nor a comprehensive, objective neuropsychological battery were used. However, despite these limitations, this study shows that in euthymic outpatients with bipolar disorder, those with suspected cognitive impairment had consumed a higher number of health resources over the previous year. These preliminary results may foster similar studies on the relationship between mental healthcare resource use and cognitive dysfunction in bipolar disorder and other psychiatric disorders.

摘要

认知功能障碍是功能结局的主要预测因素,职业功能丧失通常与更高的疾病治疗费用有关。然而,迄今为止,在双相情感障碍中,尚未研究认知障碍与卫生资源消耗之间的关系。本研究旨在探讨这种关系。这是一项在西班牙一个地区进行的、针对 18 至 55 岁之间病情稳定的门诊患者的代表性样本的观察性、回顾性研究,符合双相情感障碍的 DSM 5 标准。使用西班牙版的精神科认知障碍筛查工具(SCIP-S)筛查认知表现,并记录了前一年的多种卫生资源消耗变量。共评估了 72 名患者。根据 SCIP-S 评估的认知障碍与预定的临床就诊次数(p<0.005)和住院次数(p<0.04)显著相关,但与其他卫生资源消耗变量无关。考虑到未使用对照组和全面的客观神经心理学测试,这些结果需要谨慎解释。然而,尽管存在这些局限性,本研究表明,在病情稳定的双相情感障碍门诊患者中,那些疑似认知障碍的患者在过去一年中消耗了更多的卫生资源。这些初步结果可能会促进对双相情感障碍和其他精神障碍的精神卫生保健资源使用与认知功能障碍之间关系的类似研究。

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